A mechanical device for aortic compliance modulation: In vitro simulation of aortic dissection treatment

Zannoli, Romano; Corazza, Ivan; Cremonesi, Alberto; Branzi, Angelo

doi:10.1016/j.jbiomech.2007.03.021

Cited by 11 publications

(11 citation statements)

References 30 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Using a balloon and adjustable external reservoir with the aorta simulated by a rubber tubing, they aimed to create a device to reduce the high mortality in the presurgical phase of aortic dissections. They did this by three main mechanisms, improving coronary perfusion, slowing the dissection process, and recovering some of the mechanical e ciency of the cardiac-arterial junction (36). The disadvantage of such approaches is the associated complexity and resources required to produce these models as well as the lack of gold standard validation in a number of cases.…”

Section: Discussionmentioning

confidence: 99%

The functional limits of the aneurysmal aortic root. A unique pressure testing apparatus.

Surman

Abrahams

O’Rourke

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundThe aortic root has unique embryological development and is a highly sophisticated and complex structure. In studies that report on the biomechanical characteristics of the thoracic aorta, distinction between the aortic root and ascending aorta regions is nonexistent. Our objective is to determine the maximal pressures at which dissection occurs or tissue failure occurs in the aortic root compared to that of the ascending aorta in the presence of aortic aneurysms. This may help guide preoperative monitoring, diagnosis and the decision for operative intervention for aortic root aneurysms in the normal and susceptible populations.MethodsWe developed a simple aortic root and ascending aorta pressure testing unit in series. Ten fresh porcine hearts were obtained from the local abattoir (n=5 aortic root and n=5 ascending aorta for comparison). Using a saline filled needle and syringe, artificial fluid-filled aneurysms were created between the intima and medial layers of the aortic root. The aorta lumen was then progressively filled with saline solution. Pressure measurement was taken at time of loss of tissue integrity, obvious tissue dissection or aneurysm rupture, and the tissue structure was then visually examined.ResultsIn the aortic root, mean maximal pressure (mmHg) at tissue failure was 208mmHg. Macroscopic examination revealed luminal tears around the coronary ostia in 2/5 specimens, and in all specimens, there was propagation of the dissection in the aortic root in a circumferential direction. In all ascending aorta specimens, the maximal aortic pressures exceeded 300mmHg without tissue failure or dissection, and eventual apparatus failure.ConclusionOur results indicate that the aneurysmal aortic root tissues are at greater risk of rupture and dissection propagation at lower aortic pressure. With further analysis, this could guide clinical and surgical management.

show abstract

Section: Discussionmentioning

confidence: 99%

The functional limits of the aneurysmal aortic root. A unique pressure testing apparatus.

Surman

Abrahams

O’Rourke

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Another two clinical situations may gain from passive counterpulsation. The first is types A and B aortic dissection, which may benefit from aortic pressure pulse reduction 11 ; the second is very severe terminal heart failure. When pharmaceutical interventions fail and mechanical support (VAD, IABP) is not or no longer suitable for technical or financial constraints, passive counterpulsation may be applied in heart failure patients as a compassionate solution to move the clock of the life back a little and support the hope of patients and their relatives.…”

Section: Conclusive Remarksmentioning

confidence: 99%

“…11 The present paper investigated a selected group of patients to evaluate the efficacy of an aortic dumping system (passive counterpulsation) to recover a better clinical condition by acting on ventricular-arterial mechanical matching. This field test is important to determine the real benefits to be obtained with those of standard IABP as a reference.…”

Section: Introductionmentioning

confidence: 99%

Passive Counterpulsation: Biomechanical Rationale and Clinical Validation

Corazza

Melandri

Nanni

et al. 2013

J. Mech. Med. Biol.

Self Cite

View full text Add to dashboard Cite

Intra-aortic balloon counterpulsation (IABP) is the leading technique for cardiovascular support in most critical conditions. The beneficial effects of the procedure are widely known, but some drawbacks remain unsolved: high cost and controversial effect in presence of cardiac arrhythmia, both related to the control of intra-aortic balloon inflation and deflation. This paper describes the clinical validation of a completely passive solution (PIABP), which substitutes the time-controlled pumping system by a simple pressure-controlled reservoir. The test was performed on 10 patients, switching from IABP to PIABP and changing the reservoir pressure to obtain an optimal effect in terms of mean aortic pressure increase as an estimate of cardiac output. For each patient the reservoir pressure was increased in 10 mmHg steps and the aortic pressure was recorded together with electrocardiogram.The PIABP showed a positive effect in all the patients, with a significant increase of the mean aortic pressure (þ6.5%, p < 0:05) and of the mean pressure of the aortic pulse diastolic phase (þ7%, p < 0:05). The change of heart rate between basal and optimal effect condition was not significant. Also an unexpected, significant increase of aortic maximal pressure (8%, p < 0:05) was found.The proposed passive solution cannot be a substitute of the active one in all the situation, but may be useful in border line conditions, where the IABP is no more necessary but a ventricular support is still desirable.

show abstract

“…Zannoli et al considered the possibility of introducing a passive counter pulsating damper into the dissected aorta in order to limit the physical stress associated with ventricular ejection and increase the diastolic aorto-ventricular pressure gradient. Then a simulation experiment was carried out about it [8]. Zhang et al investigated the aortic motion and mechanical properties of aortic dissection with experimental and numerical methods [9].…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Computational Simulation of Bypassed Aortic Dissection

Guan

Chu

Yun

et al. 2010

2010 International Conference on Biomedical Engineering and Computer Science

View full text Add to dashboard Cite

To investigate the influence of bypassing treatment on the hemodynamic parameters of aortic dissection and the feasibility of this therapeutic approach in clinical application, idealized three-dimensional geometric models of DeBakey III aortic dissection with a blind lumen and its bypassing treatment were constructed with the software of SolidWorks 2007. Then, numerical simulation was performed utilizing the software of ANSYS 11.0, and the results were analyzed. The velocity of blood flow and the pressure at the entrance area of false lumen and in the false lumen are both less than those before the operation. Bypassing is an effective surgery for the treatment of DeBakey III dissection. It can effectively reduce the pressure of aortic arch and ease the impulsion and stress of blood flow on the pathological dissection. It can also alleviate the propagation, prevent the rupture, and promote the healing of dissection.

show abstract

A mechanical device for aortic compliance modulation: In vitro simulation of aortic dissection treatment

Cited by 11 publications

References 30 publications

The functional limits of the aneurysmal aortic root. A unique pressure testing apparatus.

The functional limits of the aneurysmal aortic root. A unique pressure testing apparatus.

Passive Counterpulsation: Biomechanical Rationale and Clinical Validation

Three-Dimensional Computational Simulation of Bypassed Aortic Dissection

Contact Info

Product

Resources

About